CUSTOMER ACCOUNT APPLICATION
The following information is being provided by the undersigned for the purpose of opening an account at Hudson Global Capital Ltd. (HGC) I represent that the information is true and correct and that I will promptly notify you in writing of any material changes.
Ownership of Account :
To operate Singly
To operate Joint Account as
Joint tenants with right of survivorship
Tenants-in-common
GENERAL INFORMATION - Please Print or Type
| 1. Customer's Name (in full) | 2. Spouse's Name |
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3. I/D No. / Passport Number |
4. Date Of Birth |
| 5. Citizenship : | 6. Residence Phone |
| 7. Mobile # / Pager # | 8. E-Mail Address / Fax # |
| 9. Residence Address |
10. MAILING INFORMATION FOR STATEMENTS (Check one or more of the following)
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Mandatory by Mail, address(es) as follows:
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By Fax |
EMPLOYMENT INFORMATION (LAST TWO YEARS)
| 11. Employer's Name | 12. Nature of Business |
13. Employer's Address |
14. Position Held & Years There |
COMPLETE QUESTIONS 15 TO 18 IF YOU HAVE BEEN WITH YOUR CURRENT EMPLOYER FOR LESS THAN TWO YEARS
|
15. Previous Employer's Name |
16. Nature of Business |
17. Previous Employer's Address |
18. Position Held & Years There |
FINANCIAL INFORMATION
| 19. Annual Income | US$15,000 - US$25,000 | US$25,000 - US$50,000 | US$50,000 - US$100,000 | more than US$100,000 |
| 20. Net Worth | less than US$50,000 | US$50,000 - US$100,000 | US$100,000 - US$200,000 | more than US$200,000 |
| 21. Approximate risk capital available : $ _______________ | 22. Initial Deposit : Cash ____________ | Collateral ____________ |
| 23. Do you own any property? | |
| No | Yes, Please specify: __________________________ |
BANK REFERENCES
| 24. Name of Bank & specify the branch office | 25. Type of Account(s) Current Savings Other |
26. Address |
27. Account No. |
By confirming my application for the above and by signing below, I:-
1. confirm that all information provided by me in this application is true
and I have not witheld any material information;
2. agree to enclose true copies of my income substantiation documents and other
documents as may be require by HGC, which documents
shall thereby become and remain HGC's properties;
3. authorise HGC to conduct credit checks and verify information given in this
application with any person without prior reference to me.
4. authorised and give consent to HGC to disclose or release any information
relating to me and/or my account with HGC at any time to
any party that HGC may deem fit;
5. agree that I shall execute such forms, agreements and where applicable, legal
and security documents as may be required by HGC
before HGC officer designated above upon being notified that my application
has been approved by HGC;
6. agree that opening an account with HGC, I shall be deemed to have read, accepted
and be bound by HGC Term and Conditions
(as may be amended by HGC from time to time), copies of which are available
at HGC and current copies of which I hereby
acknowledge receipt;
7. declare that I am not bankrupt and no Statutory Demand has been served on
me.
8. acknowledge that HGC has the absolute right to reject or approve my application
without assigning any reason.
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___________________________ Date: ______________________ |
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